IBD in the New World, Old World, and Your World

Abstract

Crohn’s disease (CD) and ulcerative colitis (UC) are relatively new diseases that are the by-product of an industrialized society. The incidence of the inflammatory bowel disease (IBD) increased dramatically in the Western world including North America, Europe, and Australia during the twentieth century. In contrast, the prevalence of IBD outside the Western world was low throughout the 1900s. At the dawn of the twenty-first century ulcerative colitis, followed by Crohn’s disease, emerged in newly industrialized countries of Asia, South America, and the Middle East. These epidemiologic patterns suggest that IBD is primarily driven by environmental exposures associated with the westernization of society. Identifying the key environmental risk factors of IBD is important in order to develop preventative strategies for the globally rising occurrence of IBD. This is particularly important as predictive modeling suggests that the burden of IBD will grow considerably over the next decade. In the Western world we expect a rising prevalence with an aging IBD population with significant costs driven by its management. Similarly, the rising incidence in newly industrialized countries will require these countries to adapt their healthcare systems to accommodate patients suffering from IBD.